Emergency Procedures Masterclass (Part 1)
Master life-saving emergency medical procedures such as intubation, chest tubes, lumbar puncture, pacing, and defibrillation in this course.
9 CME credits
The scapular manipulation technique is perfect for when you’re very busy and don’t have enough time to calm your patient down.
First, have your patient lay on a stretcher on their stomach, with their dislocated arm hanging down. You can leave them in this position for a while, and if they relax enough, sometimes the weight of the arm combined with relaxation will allow for spontaneous reduction of the shoulder.
Figure 1. Preparing to reduce a shoulder with scapular manipulation. Lay patient in prone on a stretcher with their dislocated arm hanging down.
If you return and the shoulder is still out, then you can add the scapular manipulation technique:
Figure 2. Reducing a shoulder with scapular manipulation. 1) Clinician places hands on the bottom, or inferior angle, of the scapula. 2) Clinician rotates the scapula to reposition the glenoid socket. 3) Assistant applies gentle downward traction. 4) Gentle internal and external rotation can be applied to overcome muscle spasms.
The reduction can be very subtle, so you may need to re-examine the shoulder intermittently.
Keep in mind, this technique is not necessarily safe if you need to administer a sedative. It’s hard to manage the airway of a patient that’s laying on their chest, and there is a risk of the patient falling off the stretcher. Choose your patients wisely when using this technique.
Figure 3. Selecting the right patient for scapular manipulation.
Great work! You’ve now covered the summary for performing the scapular manipulation technique.
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